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Palliative Care for Colon Cancer

As a cancer patient, how would you like to receive a special kind of health care that helps you — and your family — manage all the physical aspects of a cancer diagnosis, plus the psychological, social, spiritual and practical aspects? After all, cancer doesn’t just affect your body; it affects your entire life.

“Palliative care is specialized care that focuses on alleviating stress and symptoms of serious illness,” says Sarah D’Ambruoso, a nurse practitioner and palliative care professional at UCLA Medical Center.

You may hear palliative care called comfort care, supportive care or symptom management. Whatever you call it, it’s an important part of taking care of people who have cancer. In fact, the American Society of Clinical Oncology recommends cancer centers offer palliative care in conjunction with treatment for metastatic disease (cancer that has spread) and for those patients who have many or severe symptoms.

Palliative care does not treat or cure cancer; rather, it’s provided in addition to standard treatment (such as surgery or chemotherapy). According to ASCO, patients who receive palliative care at the same time as cancer treatment often have less severe symptoms and better quality of life and are more satisfied with treatment.

“Palliative care brings comfort to people with health problems,” says Brownyn Long, a palliative care nurse at National Jewish Health in Denver. “It can be long term or short term.”

[See: Creative Ways Hospitals Reach Diverse Populations.]

Long says palliative care begins with alleviating physical symptoms, such as managing pain, shortness of breath, constipation or eating problems. “If you don’t feel well physically, it’s hard to do other things,” she says. Palliative care also addresses the emotional experience of cancer. “It’s like peeling an onion. [Patients feel] anxious, worried, depressed, fearful, blue.” A multi-disciplinary palliative care team may include a social worker, therapist or spiritual counselor (or all three) who can help patients navigate these difficult emotional and social waters. Other palliative care team members can assist with the logistical challenges of cancer, such as insurance coverage or simply helping you understand your diagnosis and treatment options.

Palliative care providers identify where patients need support, Long says. “Some only need help in one area, but their needs can shift over time.” In some ways, she says, colon cancer patients have needs that other cancer patients don’t, as surgeries for colon cancer can modify the digestive tract and be disfiguring (some patients require an external pouch to collect waste). Palliative care can help them with these symptoms and treatment consequences.

Ideally, patients begin receiving palliative care at the time of diagnosis, but they can start at any point in their treatment. “Patients who receive palliative care may actually live longer,” D’Ambruoso says. She cites a study in which patients diagnosed with stage 4 lung cancer (the most advanced type) received palliative care from the time of their diagnosis. The study found they lived 2.7 months longer.

You can receive palliative care in nearly any health care setting, including the hospital, nursing home, assisted living or outpatient facility — even at home. Some palliative care treatments and medicines may be covered by private insurance, Medicare or Medicaid. Check with your insurer.

[See: When Health Treatments Go From Hospital to DIY.]

What’s Important to You?

The goal of palliative care is to improve patients’ quality of life when they’re dealing with a serious illness. Every patient’s needs are different, however, and may change over the course of their disease. An important part of palliative care is understanding what quality of life means to a specific person, D’Ambruoso says. “It requires a tailored approach. It’s important that patients and families share with the oncology team and palliative care team what they are most concerned or worried about, so we can integrate it into the patient’s treatment goals.”

Palliative Care Is Not Hospice Care

Hospice care is a bundle of services for patients who have a life-limiting illness and have decided to forego curative treatment, D’Ambruoso says. Palliative care includes hospice care, but palliative care can be initiated regardless of whether a patient is continuing to pursue curative therapy or not. The goal is always to maintain the best quality of life, even if you’re near the end of your life.

Palliative care can help patients make the transition to hospice, when the patient ends all efforts at curative treatment and their doctor expects they have less than six months left. “Family members don’t want to take away [a loved one’s] hope, so they have a fear of talking about hospice,” Long says. “But, for people who don’t have a lot of time left, hospice care can keep them out of the emergency room and allow them to take trips or create new memories.”

“So many people think palliative care means giving up,” Long continues, but that’s not true. “You can get really aggressive with symptom management through palliative care.”

[See: 14 Things You Didn’t Know About Nurses.]

Ask your oncology team about palliative care services as part of your total colorectal cancer care. For more information about palliative care, check out ASCO’s Palliative Care booklet.

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Palliative Care for Colon Cancer originally appeared on usnews.com

Don’t Settle for Student Loans to Pay for Online Education

Online college programs are becoming a more popular choice for prospective students, with one study finding that more than 6 million students enrolled in at least one online course in fall 2015. The popularity of these courses can be attributed in part to their flexibility with working adults' schedules, students' ability to progress more quickly through online programs and, oftentimes, cheaper tuition. [See 10 low-cost online bachelor's programs for out-of-state students.]Online degrees can be beneficial to many college students, but some studies have shown online learners complete their programs at lower rates than students at traditional brick-and-mortar campuses. Individuals with student loans but no degree comprise two-thirds of defaulted borrowers. Though these numbers are not encouraging, just like for traditional programs, there are ways to reduce how much you'll need to borrow for an online program to ensure you won't become one of these statistics. Don't just settle on borrowing student loans to cover the whole cost of your program and living expenses. Instead, start thinking about how to cut costs and cover your balance in different ways, such as the following. -- Grants and scholarships: Even though you are taking an online course, you can still apply and receive grants and scholarships. But your first step should be to complete the Free Application for Federal Student Aid, commonly referred to as the FAFSA, which will allow you to receive a Pell Grant if your expected family contribution is low enough. The EFC criteria and award amounts are adjusted annually, but the 2017-2018 academic year awards range from $606 to $5,920, which could significantly lower the amount you borrow annually. Your next step is to apply for scholarships. You can start by checking online scholarship search engines, such as the Salt Scholarship Search, College Board's BigFuture and Peterson's. But don't forget to take advantage of local organizations and your school's financial aid office. Both may offer scholarships that you can't find with a national scholarship search. [Review these 10 sites to kick off your scholarship search.]For instance, organizations like the Elks Club, Knights of Columbus or the Rotary Club typically offer scholarships annually to local students. Just because you're going to school online doesn't mean you're ineligible. Visit your local library for scholarship listings, and ask around town. You might be surprised how many local organizations offer scholarships. While these scholarships typically aren't large, every little bit counts. Each dollar you receive in a scholarship is a dollar you don't have to borrow and pay interest on. -- Work-study: Another option for online students may be work-study awards. Not all students enrolled in online programs are eligible, but students at some schools -- including, for example, SUNY Empire State College and Liberty University -- are. Work-study awards are not given upfront like scholarships and grants. In most cases, they are an offer to earn up to the awarded amount if you secure an eligible work-study job. While there is a misconception that all work-study jobs must be on campus, students can work for off-campus, nonprofit or public employers as long as the work is in the public's interest. You may be able to work for a for-profit employer if the job is relevant to your course of study. No matter who the outside employer is, it will need to have an established agreement with your college for you to receive work-study funds. Remember, to be eligible for federal financial aid, you must be enrolled and pursuing a degree or certificate. If you're not working toward a credential, Pell Grants and work-study won't be option, but you may still be able to take advantage of private scholarships -- just be sure to read the eligibility criteria carefully. [Explore what to know about financial aid in online programs.]-- Pay as you go: One of the great benefits to enrolling online is the flexible schedule, which can allow you to complete your college coursework around your responsibilities. But prospective students often overlook using their part- or full-time job earnings as an option for paying for college. Almost 80 percent of college students in 2015 worked at least part time while attending classes, according to the National Center for Education Statistics. By budgeting and thinking strategically about your college costs, you can likely reduce your dependence on student loans by paying a portion out of pocket. Many -- but not all -- online programs are less expensive than traditional programs and often have shorter payment periods. Six, eight or 10 weeks are common course durations. Because of the frequency of payments in an online setting, you may be well-placed to pay as you go and possibly avoid borrowing altogether. Attending college online and avoiding student loans may be challenging, but if you are willing to put in the effort, you can limit the amount you need to borrow. More from U.S. News Q&A: Understanding Student Loan Discharge Eligibility Student Loan Refinancing Isn't Right for All Borrowers
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